Enhanced Anal Cancer Screening Could Reduce Deaths by Up to 65% in High-Risk Groups

Recent research highlights the significant potential of anal cancer screening to save lives among high-risk populations. Anal cancer, which has notable morbidity and mortality rates, often develops from identifiable precancerous lesions. A comprehensive study conducted by a team of U.S.-based scientists, including Ashish Deshmukh from the Medical University of South Carolina, analyzed the cost-effectiveness and benefits of various screening strategies. The findings suggest that regular screening, particularly cytology tests every three years for men over 35 with HIV and every two years for newly eligible men at age 35, could cut the incidence and mortality of anal cancer by up to 65%. Currently, the U.S. Preventive Services Task Force lacks specific guidelines for anal cancer screening due to insufficient evidence on benefits versus harms and costs. This new research aims to fill that gap, providing data-driven recommendations that can shape future guidelines. It also considers the two main screening methods: cytology, which examines cells microscopically, and HPV testing, which detects high-risk strains of the human papillomavirus responsible for most anal cancers. The study emphasizes that screening strategies need to balance benefits with potential harms such as false positives and associated anxiety. The findings are especially relevant for populations with the highest risk, such as men who have sex with men (MSM) living with HIV, but could be adapted for other groups based on different resource availability and HPV vaccination rates. Ultimately, this research offers a valuable framework for international health bodies to develop targeted and cost-effective screening protocols, aiming to reduce the burden of anal cancer worldwide. The study also underscores the importance of continued research into screening benefits, harms, and implementation to establish clear, evidence-based guidelines.